The usually good Michael Kinsley ignored his better angels yesterday and turned in a truly muddled effortmanifesto
(full disclosure: I'm mentioned in the piece). Kinsley's article is
sold as a defense of "modest reform" against "single-payer," which he
achieves by ignoring the range of single-payer systems and, like so
many others, stereotyping single-payer as Canada. His main complaint is
that he fears rationing and, moreover, the inability of rich people to
escape it, and thus demands that private money be allowed in purchasing
health treatments, and fears that it won't be within the Kurgman-Wells,
which is to say single-payer, context.

Kinsley, usually a purveyor of progressive ideas, takes a strange turn here. He's fallen into the trap of equation government involved health care to mean "Canada".

Take a gander at Ezra Klein's The Health of Nations series which examines five countries and their health systems for just a glimpse at the different ways good health care is structured in this world.

There is nothing inherent in government involvement that bars private involvement. In fact, I'd shudder to see the U.S. in a system that does just that. There are ways to insulate against all the fears Kinsley lays out in his column. By making a place for the private market, the richest can buy as much health care as they desire.

And don't give me any more of this rationing talk. We already ration. It's just buy ability pay. Allowing supplementary private insurance in a new system allows for individuals to surpass waiting lists.

Last week I wrote about France and their private/public hybrid, a great system for the U.S. to take a deeper look at. I don't know if Kinsley is truly ignorant of health care in these countries or if he's just ignoring it. But with such a prominent stage in which to voice his opinions, I wish he'd take the time to examine all the options. He makes the case again and again for modest reforms. But with our system costing more than twice as much per person as other countries, who have better health outcomes, better equity of care, and much cheaper health systems, I've yet to see an argument for modest reform that promises to bring us up to par with them.